NEWSFLASH: OCD And The Visual System

this post is the first in a series of ‘quickies’, meant to keep you informed about interesting new developments in scientific work concerning OCD. The idea is to present something that is ‘brewing’ at the time of publication of a newsflash post; so I will not post something that is very esoteric, incredible, or seriously questioned by other and solid scientists. My newsflashes will be taken up later on in the broader context of the functioning of our brain; see them as ‘tasty teasers’ to whet your appetites.

Is there a form of visual impairment in OCD?

This question is a difficult one. There are compelling pieces of information that haven’t yet gelled into a cohesive picture. Take a person who is a ‘checker’, someone who spends hours each day on making sure whether windows and doors are closed, faucets don’t run, and electrical appliances are turned off. Now, such a person has the habit of what is called ‘compulsive staring’. He/she can need long minutes to let a signal ‘sink in’ that a faucet is really off. Normally, someone simply concludes by hearing no water running that everything is OK; but this is not so in the checker. It needs to be looked over and over again, to the point of mental exhaustion, if there’s no tap water running. This is the dreaded compulsive staring. After what seem endless attempts to find a satisfying answer, finally, that coveted ‘no’ kicks in, and the patient can move on to another faucet, or appliance. All that time he/she sees, and indeed, knows that things are in order, but as soon as the eyes are averted, for doing checks elsewhere, insecurity triumphs, and this person has to go immediately back to that tap I spoke of.

You will understand that this is an enormous problem, very disruptive for normal life; and moreover, it completely seems to defy everyday logic. It’s even worse: it has been found out that the longer a checker spends on these control measures for one single object or situation, his/her insecurity increase. It’s a vicious circle indeed.

In my own situation, I developed the weird habit of talking to myself. Hearing myself say to me: ‘It’s off. It’s really off. You know it’s off’ somewhat alleviated the fear and decreased the duration of the rituals. But I missed so many trains, dinners, and other duties and appointments, that I don’t even want to know the number of missed opportunities. I would get severely depressed of knowing it, in fact.

Problems related to the visual side of OCD have also been described for hoarders and people with contamination fear. Take our student Iris. She often experienced that whilst being led around the group of patients assigned to her, she could get enormously distracted by some tiny stain somewhere, or a little fly. So intensely, that she could not understand anymore what the chief doctor was telling her about a patient’s condition. Again: for Iris, threat-related stimuli (i.e. things that made her own fear-related mental programs running like mad) meant that in the days her illness was kept secret and not treated, she was seen as mentally absent and as an underachiever.

The above examples make clear that the visual system may very well be implicated in obsessive-compulsive disorder. The emphasis lies on seeing, looking, staring, and not on feeling, hearing, tasting, or smelling (although the other senses may be called into action as a secondary ‘help-line’, see my own tactic above).

I would conjecture that numerous OCD-related disorders are connected to deficits in the visual system; I would even go so far as to say that neuro-developmental issues are involved. To me it seems plausible that a girl who was permanently driven by her mother to devote excessive attention to her good looks, at the cost of normal social interaction, may be disposed towards developing forms of body dysmorphic disorder, anorexia, or boulimia; a genetic susceptibility could be all that’s needed to make these disorders florid.